A six-year-old girl obsesses
over her weight, while another young girl eats paper instead of
food to fill up. Why are prepubescent girls developing eating
disorders?

Sydney Forbis seems like an ordinary teenager: She wears skin-tight
clothing, worries about her figure and painstakingly picks out
each new outfit when she goes shopping with her mother.

The extraordinary thing about Sydney is that she is only 6 years
old.

"I think sweatpants make my legs look fat," she said on ABCNEWS'
Good Morning America. Even though she is thin, the little
girl said she runs to keep her weight down. "I don't want the
fat to spread all over my body."

Eating disorder experts say prepubescent girls are developing
eating disorders as young as 5 and 6 years old. They may be getting
their obsession from parents who are preoccupied with their own
body images, and media images of skinny pop stars like Christina
Aguilera and Britney Spears, the experts say.

Dr. Ira Sacker, an anorexia specialist who founded the organization
Helping to End Eating Disorders, or HEED, told Good Morning
America he has been treating a lot of very young girls for
eating disorders.

One of Sacker's young patients, Justine Gallagher, started eating
paper when she was 5, because she worried that she was as chubby
as she had been in her baby pictures. Gallagher ate as many as
10 pieces of paper a day, believing that filling up on paper 
rather than food  would help her lose weight.

"I thought if I ate my regular meals that I would get heavy
and people would make fun of me," Justine said.

Her teachers noticed that pages from her books were missing,
and at home her mother found that she was also eating the cotton
from Q-tips. Her mother, Yvonne Gallagher, then took Justine to
three separate pediatricians, but they all told her it was just
a phase that Justine would grow out of.

One night Gallagher walked into her daughter's bedroom and found
her running laps with a timer. "She said, 'I ate too much today.
I have to exercise.' That was really the breaking point," Gallagher
said. She took Justine to Sacker, who recognized that the 5-year-old
had an eating disorder.

Rather than force-feed his patients, Sacker tries to help them
build up their self-esteem. During Justine's treatment, he discovered
that she loved horseback riding, and began using that activity
as a way to help her replace the dieting obsession with healthy
activities. She could only ride the horse if she got rid of a
piece of paper each day. Now 10, Justine has recovered from the
disorder, and is participating in a school play.

Dieting Just Like Mom

The onset of anorexia nervosa has two peaks, one at ages 10
to 13, and the other at ages 13 to 18, said Dr. Gene Beresin,
an associate professor of psychiatry at Harvard Medical School.
Only 6 percent of those affected are men. Researchers say the
causes range from genetics and family problems, to lack of self-esteem
and the media's portrayal of thin women as ideal. But the underlying
emotions are the same.

"The hallmark of the disorder is fear of getting fat and a gross
distortion of body image," said Beresin, who is also the director
of child and adolescent psychiatry training at Massachusetts General
Hospital in Boston.

Experts say the children who develop eating disorders are mostly
girls who are often following examples set by their mothers.

"The majority of the young children we see or hear about who
are over concerned about their weight, interested in dieting,
or who have already developed a distorted body image have mothers
who are preoccupied with their own bodies," said Susan Willard,
director of the Eating Disorders Treatment Center at River Oaks
Hospital in New Orleans, and a professor of psychiatry and pediatrics
at the Tulane University School of Medicine.

The mothers, she said, "devote a great deal of time and energy
to dieting, exercising, counting calories and fat grams, and expressing
their own displeasure with their bodies."

Is Barbie to Blame?

Any child watching prime-time TV is also exposed to ultra-thin
women. "How many adults talk about dieting, looking greater as
they become thinner and thinner?" Beresin said.

According to recent studies, many fifth- and sixth-grade girls
have tried to lose weight, Beresin said. It doesn't mean that
they will develop anorexia nervosa, but it does mean that they
are feeling the crush of cultural and social pressure, he said.

"As an example, look at the figure of Barbie. Her figure is
an impossibility for any young girl or woman to achieve, and yet
it is the image of beauty," Beresin said. "How many girls yearn
to look like her, or other dolls of the same image?"

Part of the solution lies in changing how we, as a culture,
portray images of men and women and how we treat people who are
overweight, he said.

"There is no doubt that our culture, and especially upper- and
upper-middle-class cultures promote this disorder," Beresin said.